So whilst I have no problems understanding anddifferentiating the different types of acidosis and alkalosis, I cant grasphow the renal system responds to acid/base problems at the molecular level. Anyone care to help me out?
Kidneys respond to acidosis in 2 ways:
- HCO3- Reabsorption:
o H2CO3 is converted toH2CO3, H2O and CO2 in the tubules and H2CO3 and CO2 is reabsorbed. Surely thisisnt only recycling, but in fact proton secretion as two H+ are excreted in H2O?
o H2CO3 is converted to H+and HCO3-, the H+ is buffered by another anion, namely NH3 from NH4+ from theconversion of Glutamine to Glutamate. The HCO3- is absorbed. Here, if NH4+ iscreated from Glutamine, and NH4+ is what is excreted in urine, surely there isno net H+ excretion?